“The Biggest Loser” Study Doesn’t Prove Weight Loss is Impossible!

When weight loss is in the news, it inevitably revolves around the idea that it’s impossible to do, or if you do manage to do it, it’s impossible to maintain. This is a popular story because most of us are fat, and by us I mean “all humans” and by “fat” I mean “overweight or obese.” And most of us don’t want to be fat any more, for a variety of reasons. And while most of us know that we just need to eat less and move more to lose weight, most of us find it very hard to do, and it’s honestly comforting to think that it might not be our fault.

In fact, I’ve been fat, and a few years ago I lost about 20% of my total body weight. According to many headlines, including a big recent New York Times article, I am either an incredible outlier or a future failure who might at any moment balloon out, Violet Beauregarde-style.

In the study featured in the New York Times, researchers followed contestants on the reality show The Biggest Loser for 6 years after the show’s finale, finding that they all gained weight back and had done great damage to their metabolism in the process. For instance, Sean Algier originally weighed 444 pounds, got down to 289 on the Biggest Loser, and six years later weighs 450 pounds. He “now burns 458 fewer calories a day than would be expected for a man his size,” which makes weight loss even harder.

That’s a scary finding that probably had a lot of NY Times readers ready to stop counting calories and just embrace their bodies as is. But is it true, and is it applicable to the majority of people who want to lose weight?

You may have guessed by now that my answer is “no” and “no.”

I agree that the study is very interesting, but there are also some pretty big (pardon) issues with it. For a start, I’ll throw out my usual complaint with a lot of studies with incredible results: the sample size is too small. This study involved 14 people. No matter what the results are, a study with only 14 data points needs to be replicated before being given a New York Times spotlight.

And these 14 people are extraordinary! They all lost incredibly dangerous amounts of weight in ridiculously short periods of time under the guidance of professional trainers and specialists. It’s not just that their results aren’t typical — this would be like studying astronauts who live in space for a year to determine what happens to your body when you go on a looping roller coaster once a summer.

Third, the people profiled haven’t failed to keep weight off. One of them failed. The others have regained some fat, which of course they did! They lost all that weight and then went out into the world with zero support or understanding of how to maintain! But they’ve managed to keep off a huge percentage of their total weight, like Danny Cahill, who is presented in the article as a complete failure but who weighs 130 pounds less than before he went on the show. 130 pounds is an entire person!

Finally, there’s the problem with the researchers’ evaluations of how many fewer calories these people are burning compared to other people of their size. They can’t actually compare the subjects’ metabolism to an average of all people at that weight, since we don’t have that kind of data. So they used a linear algorithm, the simplest equation possible that will fit their data of 14 obese subjects. Depending upon what algorithm you use, you can come up with very different results, including results that are much more in line with previous research on the subject.

Does this mean they chose the wrong algorithm? Absolutely not! All it means is that before we make any conclusions, this study needs to be replicated using all the same techniques but with more data points. Only then can we really talk about what extreme weight loss does to morbidly obese people. And even then, we can’t necessarily extrapolate to people like me, who were overweight and lost enough to reach a healthy weight.

The moral of the story is that if you want to lose weight, your best bet is still to eat less, move more, and don’t believe everything you see on reality television. Or everything you read about reality television.

Rebecca Watson

Rebecca leads a team of skeptical female activists at Skepchick.org. She travels around the world delivering entertaining talks on science, atheism, feminism, and skepticism. There is currently an asteroid orbiting the sun with her name on it. You can follow her every fascinating move on Twitter or on Google+.

36 Comments

Well, moving more doesn’t seem to actually help the average person. The body has a lot of compensatory behaviors that cap out the number of calories spent per day. If you go out exercising, you’ll be worn out afterwards and rest more than you otherwise would, balancing out the expenditure (it’s still beneficial for your cardiovascular system and muscles, but it doesn’t do much to help you lose weight), for instance.

Eating less is the trick, but not too much less – that seems to affect your metabolism in ways to make it extra efficient, making it harder to maintain the weight loss. The recommended target is approximately 500 kCal less per day, which comes to about one pound of weight loss per week.

And “move more” does not necessarily mean “spend an hour in the gym”. It could mean ride your bike to work instead of your car or use the stairs instead of the lift. Or instead of ringing your coworker in another department, just get up and go to their desk and talk to them.

Definitely better for health overall, but when the specific goal is weight loss, the common “eat less, move more” refrain implies that the two recommendations are on equal footing, which is far from the truth. From my own experience losing weight, I tried to focus on the “move more” route first, only to find absolutely zero weight loss, and I wouldn’t be surprised if other people have done the same. Focusing simply on the “eat less” side of things would help avert this.*

*With “moving more can help a bit too, and has other health benefits” in a footnote, or otherwise qualified that it doesn’t have the same impact on overall weight.

Jesus, is there anything more self-righteous than an ex-fattie? You’ve managed to keep the weight off, Rebecca? Well, good for you, if that’s what makes you happy.

Fact is, though, that “eating less and moving more” doesn’t work for many if not most of us. In order to be thin, I’d have to literally be in a state of starvation every fucking day, amd you know what? Despite your smug ideas of what I “should” be doing, I’d rather, y’know, live a fucking life.

I’ve done everything smug asshole like you say I should for YEARS, and as much as you want to stick your fingers in your ears and scream about how I must have been doing it wrong, how I’m lying, how I’m not capable of assessing my own life, how I’m just a lazy fucking fat pig who has no self control and is too stupid to change, guess what?: YOU’RE WRONG.

I’m sorry if the reality that for some people long-term wight loss means lives so miserable they’re not worth living scares you. That doesn’t mean it’s not true. But get off your fucking high horse. You may be luckier than me, but you are in no way better.

You seem to think I was recommending that you, personally, eat less and move more. I was not. I was recommending that to people who want to weigh less. You’re under no obligation to weigh less. You should be at the weight that makes you happy.

As my first comment is in moderation, just wanted to add that telling people to “eat less” is phenomenally stupid, because for many, many people, eating the recommended amount of fruits & vegetables would drastically *increase* the volume of food they consume – even if they cut back on other things. But I guess when you’re so invested in the myth that fat people are fat because they’re constantly shovelling the food in, it’s pretty hard to see what real people do in the real world.

And re Infophile’s exciting observation: gee whiz, only 500 calories less per day? Wow, so when I was gaining weight while on about 1500/day, that would’ve made it a totally practicable 1000 WHOLE ENTIRE calories a day. Who wouldn’t want a life like that? After all, the fact that that wouldn’t have given me enough energy to hold down a job, let alone do anything else with my life is just lazy fatso complaining. No one *needs* to work, or think, or have any activities in their lives apart from those directed towards maintaining a weight acceptable to Rebecca & Infophile.

This doesn’t even touch on the reality that even if what you two are saying were true (which it is not), it would still be out of reach for most. I’m a middle-class single person on a reasonable income and I find buying & preparing healthy food both expensive and time-consuming. I have to make a lot of effort to get in enough time to exercise and, where I live, I also have to pay for it as just getting out for a brisk walk isn’t always possible. Most people aren’t as lucky as me in terms of either time or money.

So all this bleating on about moving more and eating less is pointless for most of the people you’re directing it to.

And yeah, shocker: I do in fact probably eat more reasonably than most people, and I have certainly been more active than most for decades now. And guess what? Still fat! Sorry to burst your theoretical bubble…but I’m sure you’ll rationalise it away and come to the conclusion that because “fat” = “lazy overeater,” I must be either delusional or a liar. Anything rather than admit you might be wrong.

For the record, I know how difficult it can be to eat healthily. Not for middle or upper-class people, as a whole, but for lower-class people without access to grocery stores and for all people who lack food and health education. Additionally, eating “healthy” foods is not the easiest way to lose weight (if that’s what you wanted to do). You can eat nothing but Twinkies and lose weight — you just have to eat fewer than the number you burn in a day. And you’ll probably be hungry af all day because carbs don’t keep you full for long.

I’m usually a fan of your videos, but not so much this one. No, The Biggest Loser tells us nothing new about attempts to change one’s weight in the real world. It is a tiny sample. It does, however, back up the anecdotal experience of millions of people who have attempted to change their weight significantly on their own, as well as the published findings of literally thousands of studies. Your sample of one is of course even tinier and incapable of extrapolation to the world at large.

In order to lose weight one’s best bet may be to move more and eat less, but since the odds are 97:3, it’s a lousy bet for anyone except the house.

I’m happy for you that you successfully lost 20% of your body weight and have been able to maintain your preferred weight for a few years. Seriously, that’s great. And I hope for you it isn’t as time-consuming to maintain that weight change as it is for most of the 3% who manage it. But for the love of fat, acknowledge that you are an outlier and that your experience is of even less use to the vast majority of people than The Biggest Loser study.

I’m sorry, but you are quite obviously in the wrong here. As I stated in the video, the Biggest Loser study does not back up thousands of studies. Previous studies on metabolism after weight loss stand in stark contrast to this one, which is why it’s catching headlines.

Agree on this specific study sample size being an issue, but I also agree with the previous commenter. I thought it was pretty well established at this point that recommending more dieting and exercise is not going to reduce obesity and I’m pretty uncomfortable with the “own fault” aside.
I hope you did not mean it the way it sounded to me.
From my perspective, the majority of people for whom dieting doesn’t work should absolutely come away from that broader research with the conclusion that it doesn’t work and those selling them the idea that it does should maybe invest in the hard work of finding a real solution instead of telling them it’s their own fault?

It is not well-established that recommending more dieting and exercise doesn’t “reduce obesity.” In fact, in every study in which people reduce their calories in a well-controlled environment, the subjects lose weight. It’s physics.

I kind of feel like we’re not talking about the same thing. I don’t deny the physics of fewer calories in and more calories out.
As an analogy I also don’t deny that if everyone abstained from sex they wouldn’t get pregnant.
I guess I’m just saying that in both cases, as I understand it
1) abstinence as a strategy doesn’t work, even if when if I locked someone in a room with noone else under clinical conditions they would not get pregnant. So just practically it’s not a good solution.
2) Willpower is kind of a reductive way of talking about it that doesn’t feel super helpful. For instance, presumably we don’t think people 50 years ago simply had more willpower than people now. It doesn’t take into account all the ways in which where you live, the food that’s available to you, what your job is, how not eating impacts your ability to function, etc. might be different between people either.

So yes, abstinence works if it weren’t for a lack of willpower. So what?

Maybe a clarification on my original comment. I didn’t say that if everyone ate less and exercised more they would not loose weight (which I think is what your response addresses?).
I just said I think the scientific consensus (according to science based medicine) is that promoting that as a solution doesn’t work for most people most of the time.
Like telling people they can loose weight if they would just do that and it’s just willpower is not effective at reducing obesity,

Ah, yes, you’re correct that there are underlying reasons why people are unable to eat less. They include easy access to food, poor education (not understanding the importance of calories to weight loss), lack of data (calorie counts) and yes, lack of willpower (more so at the grocery store than at home).

None of that means that the basic fact should be ignored: if you want to weigh less, you have to eat less. Millions of people follow that and lose weight every year. I am not an outlier.

Hrm. So the problem for me is
1) I’m hearing the willpower thing as a judgement on people who are overweight rather than an understandable result of who knows what other factors that are not under someone’s control.
2) It sounds like you are saying that there is a problem we need to solve where overweight people are not aware and have not been told that if they get some willpower and eat less and exercise more they would loose weight.

#1 bothers me because it apart from being a bit mean it just seems obvious to me that it can’t be (at the root of things) willpower unless we’re willing to entertain the idea that we have less willpower now than previous generations.
#2 bothers me because that doesn’t seem factually true (based on science based medicine) and also might encourage people to tell overweight people the same thing even more (which again seems a bit mean) and still not accomplish anything (so for no reason).

I’m hearing the willpower thing as a judgement on people who are overweight rather than an understandable result of who knows what other factors that are not under someone’s control.

Why can’t it be both a (partial) problem of will-power and an understandable result of other factors? There are many things that are outside of our control that impact our behaviors. Recognizing those things allows us to more easily change our behaviors. My upbringing influenced my behavior of yelling a lot when having a fight with a significant other. One significant other pointed it out to me and now I’ve changed my behavior, though it was difficult to do.

It sounds like you are saying that there is a problem we need to solve where overweight people are not aware and have not been told that if they get some willpower and eat less and exercise more they would loose weight.

One problem for people who want to lose weight (not for me or for anyone else) is that they are fed a lot of bullshit about what they need to do to achieve their goals. Understanding the role of calories will help them, as it has helped many, many people. It’s the first step, after which they can find tools to help with things like willpower. For instance, one thing I learned was that it feels impossible for me to resist snacks once they’re within reach. It’s much easier for me to say “no” to them once at the grocery store than repeatedly all day long at home. I haven’t adjusted my willpower, I’ve just developed a way to work with it.

Sure. I don’t think we’re diagreeing vigorously at this point:P
Just to back up to the top I think maybe the thing that’s gotten lost here is that I don’t think you meant to say (paraphrasing unfairly as how it sounded) “Weight loss is possible if you just eat less and exercise more like I did. If you just admit you need more willpower instead of pretending that calories don’t count you’d loose that weight”
But that’s a bit how that part (in the video not necessarily at this point in the conversation) came across and I think why some people responded the way they did. I did not get the impression (and I could be wrong) that everyone was trying to dispute that calories are physics and I think that’s where the miscommunication was coming in. (although I can only speak for myself).

Anyone else kind of feel like contributing to the comment section is a bit like talking to yourself?:P
Hey infofile. I think I saw you over at the-orbit? I don’t think I’ve seen you before Kathie Douglas.

Rebecca, spot on analysis, I agree and said something similar about this research in an earlier thread, i.e. most people were in fact better off weightwise than when they started.

I’m sure you read the original paper, and I just spent the last hour or so going thru it. Did you notice the total lack of controls? The later (6 year) BMR measurements were significantly lower but were done on different instruments! Controls could have determined whether this was an analytical or a true difference.

Despite that, the finding of a reduced metabolic rate at the end of the program was not a predictor of weight regain. On the contrary, the biggest overall weight loss at 6 years was in those whose metabolic rate reduction was greatest. So reduction of metabolic rate was not a cause of weight regain.

Also, did you notice that the algorithm for predicted BMR was determined from the baseline results for only these 14 subjects?! Talk about weak data!
Still, they say the results were similar to a widely used method, used in many online calculators, namely Miflin (reference 12).

The Mayo Clinic calculator, OTOH, has a 200 cal/day discount in the obese range which results in a discontinuity in the calculation of calories vs weight: this has been the subject of some online ridicule , but I wonder whether Mayo are allowing for reduced metabolic rate?

Thanks again for the 500 cal/day deficit diet tip. I must be another one of the extreme outliers as I followed your method to the letter with similar success to you and remain at a similar weight over a year later.

“what should now be the real focus – how to maintain a permanent change in habits to effect a more healthy or appealing weight? Only about 5% of the population can seem to do this. Will power alone (the preferred method by default) is notoriously ineffective. Some basic principles have been established – long term weight control correlates with sustainable changes in habits (not short-term diets) and correlates strongly with exercise. Common sense dictates others – healthy habits are more likely to be sustainable if they are easy and appealing.”

namidim, I agree with what you are saying.
I could share a few tips on motivation, but:
1. I will be accused of being a smug asshole – maybe not by you but by others who are in denial, as I once was.
2. You/we each have to do it our own way, and only then if we want to.

Suffice to say that for me, a dose of cardiac pain and an unequivocally abnormal GTT were a powerful motivator. That and the realisation that I could diet my own way with food I like, or suffer a lifetime of nagging from my GP, some fucking dietician who wants me to eat cardboard, and She Who Must be Obeyed.

So one tip is, there is light at the end of the tunnel, I enjoy food now more than ever, life is exciting and not boring, I delight in finding new and tasty foods that fit the bill of nuts, meat and a shitload of veg. This is the 21st Century, not the 1950s. Meat and veg includes beautiful Italian style cotoletta and Osso Bucca (Italian – without the pasta) and also divine Asian style curries (Asian – without the rice). All I have to do is give up the rather bland carbs (bread, rice pasta, baked goods and sweet kiddy shit).

I don’t doubt you are in this for the right reasons.
Generally though I wouldn’t give people advice unless they ask for it. Particularly if they get a lot of unsolicited advice.
There is a real cost when we keep telling people that they should be able to do something that almost noone in the same category as them actually does and then cast that as a personal failing. (being in denial, lacking willpower, just not being truly interested in being healthy, etc.)
We’re making 95% of them feel terrible about themselves. In addition to still being overweight. That’s not an improvement and frankly probably part of what leads to distrust.

Hey, look, I would not presume to tell anybody else what to do. I was just telling my story in the hopes that it might show somebody out there that it’s not all necessarily doom and gloom. Just as Rebecca’s words last March helped me. If you or anybody feels it does not apply to you, it is no skin off my nose whatsoever.

And, you quoted Steve Novella asking “how to maintain a permanent change in habits to maintain a healthy or appealing weight”, which kind of begged the question.

But again we all have to do it our own way, and then only if we want to.

I get that. In that quote’s case though I think the question it’s begging is more rigorous research into why people can’t stick with it and what works where we withhold making a call (and as a society bombarding people with advice) until we actually have an answer.
The outcome might be personal advice to individuals, but it could also be informing social programs, city planning, etc. or it might continue to be that there is no known effective approach.

The diabetic professionals are already all over this and manage much better than 5% compliance. I mean, they are the experts who have been battling this problem for the last 100 years or so.

I don’t know what the situation is in the US and I know inequality is at 3rd world levels there but in Australia once diagnosed an impressive host of services including specialised dieticians become available free of charge.

The problem as I see it is to ramp up a cut down version of the excellent diet related services already available to diabetics (but only when it is already too late) by an order of magnitude and make hem available at nominal cost for the obese population.

Excellent points, Jack. There were a lot of possible issues in that study, and I’m sorry I didn’t hit on those because they’re strong indicators that this is just never going to be replicated. Of course, we won’t hear about it not being replicated. Sigh.

14 subjects is not a scientific sample. But it is a clear demonstration that the fat-shaming, eating disorders, and self-battering exercise actively promoted in contemporary culture are NO HELP TO ANYONE.

I weigh 70 lbs less than I did 12 years ago. 40 came off slowly over about 5 years. The last 30 in 6 months when I went to a low carbohydrate regimen to manage diabetes. That was 6 years ago. I still weigh around 175.

Eating differently seems more important than trying to eat less. I monitor carbohydrate intake and stay below 50 gr per day about 80+% of the time, and always under 75 gr unless I’m going off the reservation for a holiday dinner or such. So my caloric intake is probably lower than it was, but not by restricting quantities. My intake of fats, vegetables, nuts etc. etc. leaves no room to feel deprived. I don’t go hungry every.

I get what I have to do. Count calories. I don’t know about you, but counting calories takes a long time. If I prepare meals from scratch at home, there’s not a nice little number on the back of the box to tell me how many calories I ate. I takes time to look up all the ingredients and write them down. If I change up recipes, it takes even more time. If I want fresh foods, I have to go to the store several times a week. I think some of this is what namidim was trying to say: I don’t have time to devote to doing all this and still make time for my family and hobbies. And I get that if I want to keep weight off, I have to do this forever. I know!

And it’s not like I haven’t tried what you say. It’s because I’ve done it that I know so well how it works and how time consuming it is. I’ve tried to stay on it for months. I ate 1200 cal/day and I lost maybe 5 lbs. Was I doing it wrong? Was my calorie counting off? I don’t know. But it’s frustrating to not see much in the way of results.

Also, I don’t like getting rid of carbs. Goody that it’s easy for you. For me, they seem to help me digest food. If I eat veggies or meat without carbs, my stomach gets upset and I get heartburn and feel sick. That makes me not want to give up carbs.

I don’t expect you to have answers, I just wish that you would acknowledge that some things are more difficult for other people. If that makes me an ‘enraged accepter,’ fine, whatever. Mock me. I dislike banging my head against a wall over and over and over.

Nope, it doesn’t! When I was losing weight I used My Fitness Pal to count. It’s free, has a desktop or mobile app, and a has a huge database of foods already in there. You can even build recipes, or import them from around the internet. I also used a cheap digital scale from Amazon to make sure I got the count right.

In maintenance, I don’t use it. I’ve been doing it long enough now that I know where the calories are and I know how to pay attention to all the things I didn’t before, like a piece of candy here, a soda there, 4 beers over here, etc. I occasionally go back to MFP if I’m feeling like I’m backsliding, but generally I’ve internalized the calorie count.

I never gave up carbs. Some people do, because eating a high-protein diet helps a lot of people stave off hunger. A little hunger doesn’t bother me, but going without doughnuts and pizza does. So, I made the choices that made me happiest, which allowed me to stick to what I was doing.

I’ve never said that it wasn’t difficult. It is! And it’s even more difficult for people who don’t know the importance of calories and how easy it is for us to fool ourselves into thinking we’re eating the right amount when we’re actually way, way off. And it’s more difficult for people who think there is a complex equation they need to solve in order to lose weight. That’s why I (very occasionally, because the hate I get in return makes it a bit stressful) speak bluntly about the scientific fact of weight loss.

Yeah, I used MFP, too. I don’t think it made it easier. Many listings are confusing, with numerous entries. I often had to recalculate between ounces and cups. I hope I guessed right at how much that pasta that was that I cooked. What if I pour off some of the grease from the hamburger meat that I cooked? Do I use the pre-cook or post-cook weight of that steak? Maybe you didn’t have these questions, but I did.

Even so, I still did that for months, 1200 cal/day. Only ~5 lbs. lost. But the science is infallible/unquestionable, so it’s totally my fault. That makes me feel great about myself and totally helps me want to continue to try to be healthy in the future.

The only thing that doesn’t make sense is: if it’s so goddamn simple, why is this such a fucking problem? The only answers seem to be willpower or motivation, so if it didn’t work for us, we must be lazy-ass losers. Again, terribly helpful for making me want to lose weight.

I’m not sure what you want me to say, here. I’m not here to convince you to lose weight. It sounds to me as though you just don’t want to, because the effort is too great. That’s absolutely fine and no skin off my back. It’s as if you were complaining that you wanted to learn chess but you didn’t feel like memorizing all the different pieces’ roles and you didn’t like the computer programs set up to teach you. It’s fine! Play checkers instead.

You keep repeating that you “only” lost 5 pounds, as though that means anything to me. Some people want to lose 5 pounds and would consider that a success. Some people just don’t want to keep gaining weight and would consider that a wild success. Some people want to lose more and would consider that a great start. You seem to consider it a failure, and to consider yourself a “lazy-ass loser,” which, okay, that doesn’t seem like a great mindset but it’s your life. But I’m not sure why I or anyone else is to blame for it.

It is simple, but that doesn’t mean it isn’t hard. It was hard for me at times, but I did it because I needed to. If you don’t need or want to enough to overcome the difficulty, that’s not a moral failing on your part and I hope that you can one day come to see that.

I spent a whole week going up the wall reading nutrition info off all my favorite foods (written in the special font they use for nutrition data, flyspeck zero point), doing spreadsheets and being scared and hungry and feeling TRAPPED!

Soon patterns began to emerge though – like it didn’t matter much which vegetable or how much and that about 200g of most meat was OK. And I weighed myself twice daily and the kilos came off when I was on the right track, but not when I made mistakes. And going up and down is normal and OK.

I still don’t know if chicken thighs 100g are 119 or 207 calories though!

I can’t say I see the smugness in this… that said, I read the article rather than watch the video, so maybe it’s just down to your voice which, uh, no offence, always sounds a little smug (it’s probably just the accent).
If this study tells us anything repeatable, it’s probably just that the kind of diet and exercise regimen promoted by programs like “The Biggest Loser” (who the fuck comes up with these titles?) are unsustainable, which is unsurprising, and probably not particularly controversial. I haven’t seen the US version of the show, but my mum used to watch the UK version, and it was practically starvation diets and ex-military trainers screaming at them about pain and gain. How is that supposed to help anyone?
Move more and eat less may be a bit of a simplistic way to express it, and it’s slow going, but it certainly has better long term results than any diet I’ve come across.

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The Skepchick Network is a collection of smart and often sarcastic blogs focused on science and critical thinking. The original site is Skepchick.org, founded by Rebecca Watson in 2005 to discuss women’s issues from a skeptical standpoint.